| NPI | 1740585330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARIE MCKINNEY Therapist 616-456-6571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6401011001) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2011-01-13 |